Provider Demographics
NPI:1508880352
Name:WILLIAMS, BENJAMIN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:PAUL
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CHEROKEE RD
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-3402
Mailing Address - Country:US
Mailing Address - Phone:706-647-3200
Mailing Address - Fax:706-647-2346
Practice Address - Street 1:202 CHEROKEE RD
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-3402
Practice Address - Country:US
Practice Address - Phone:706-647-3200
Practice Address - Fax:706-647-2346
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031686207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine